University of New Mexico, Continuing Education Division
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Advanced Hospital Coding and CCS Prep

$1,895.00 (USD)



When you've successfully completed this program, you'll:
  • Understand how health information travels within departments of a facility
  • Be able to define the roles and responsibilities of a coder in both in- and out-patient facilities
  • Know how to interpret health-record documentation using your knowledge of anatomy, physiology, clinical disease processes, and medical terminology
  • Accurately assign codes for diagnoses, conditions, problems, or other reasons for patient encounters 
  • Select codes according to Uniform Hospital Discharge Data Sets (UHDDS) definitions and official coding guidelines
  • Evaluate the effect of code selection on Diagnosis Related Group (DRG) assignment, and verify DRG assignment based on Prospective Payment System (PPS) definitions
  • Determine proper use of Modifiers, CPT vs. HCPCS Level II codes, and Medical Necessity (linking diagnosis to procedure or service)
  • Understand reimbursement methodologies and documentation rules and regulations
  • Identify the Charge Master and its components
  • Understand the CPT guidelines, with special emphasis on surgery coding
This program will help you become competent in these hospital-based coding areas:

Data Identification
  • Read and interpret health-record documentation to identify diagnoses and procedures
  • Apply your knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to assign accurate codes
  • Apply knowledge of disease processes and surgical procedures to assign non-indexed medical terms to the appropriate class
Coding Guidelines
  • Use current approved coding guidelines to assign and sequence the correct diagnosis and procedure codes for hospital inpatient services
  • Apply knowledge of CPT format, guidelines, and notes to locate the correct codes or correctly use an unlisted procedure code for a patient encounter, and sequence the codes correctly
Regulatory Guidelines
  • Apply Uniform Hospital Discharge Data Set (UHDDS) definitions to select accurate codes
  • Determine the appropriate principal diagnosis for patients who have more than one ailment
  • Use the Prospective Payment System to confirm a DRG assignment
  • Prevent fraud by maintaining approved coding principles and guidelines, including the National Correct Coding Initiative (CCI) 
  • Use the Ambulatory Surgery Center (ASC) Payment Groups to confirm ASC assignment and ensure appropriate reimbursement
  • Use the HCFA Common Procedural Coding System (HCPCS) to appropriately assign HCPCS codes for outpatient Medicare reimbursement
  • Understand which diagnoses, conditions, and procedures to exclude from coding
  • Apply your knowledge of ICD-10-CM instructional notations and conventions to locate, assign, and correctly sequence codes
  • Facilitate data retrieval by recognizing when more than one code is required to adequately classify a given condition
Data Quality
  • Clarify conflicting, ambiguous, or nonspecific information appearing in a health record by consulting the appropriate physician
  • Participate in quality assessment to ensure continuous improvement in ICD-10-CM/PCS and CPT coding and collection of accurate health data
  • Demonstrate ability to recognize potential coding-quality issues from an array of data
  • Apply policies and procedures on health-record documentation and coding that are consistent with official coding guidelines
  • Contribute to the development of facility-specific coding policies and procedures








University of New Mexico, Continuing Education Division
Division of Continuing Education
1634 Univeristy Blvd. NE
Albuquerque, NM 87131 US

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